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Premonitory symptoms in migraine: an electronic diary study.

N J Giffin1, L Ruggiero, R B Lipton

  • 1Institute of Neurology, Queen Square, London, UK.

Neurology
|March 26, 2003
PubMed
Summary

Migraine sufferers can accurately predict oncoming headaches using premonitory symptoms. This study highlights the importance of early warning signs in migraine management and understanding the condition.

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Area of Science:

  • Neurology
  • Clinical Neuroscience
  • Pain Medicine

Background:

  • Migraine attacks often include non-headache symptoms preceding, during, and following the headache phase.
  • Premonitory symptoms, occurring before a migraine attack, have been under-researched.
  • Understanding these early symptoms could significantly impact migraine pathophysiology and treatment strategies.

Purpose of the Study:

  • To investigate the predictive value of premonitory symptoms in migraine headaches.
  • To rigorously study non-headache symptoms that occur before migraine onset.
  • To explore the implications of premonitory symptom accuracy for migraine management.

Main Methods:

  • A 3-month multicenter study utilizing electronic diaries to record non-headache symptoms.

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  • Recruitment of patients reporting premonitory symptoms for at least two of three believed-predictive attacks.
  • Daily prompted and patient-initiated diary entries, preventing retrospective alterations, capturing symptoms across all migraine phases.

    • Main Results:

    • Ninety-seven patients provided usable data, with 72% of diary entries showing accurate prediction of migraine headaches from premonitory symptoms.
    • Common premonitory symptoms included fatigue (72%), difficulty concentrating (51%), and neck stiffness (50%).
    • Patients experiencing significant premonitory symptoms were more likely to accurately predict their headache onset.

    Conclusions:

    • Migraineurs reporting premonitory symptoms can reliably predict impending full-blown migraine headaches.
    • The study validates the use of electronic diaries for capturing real-time migraine symptom data.
    • Accurate prediction of migraine attacks from premonitory symptoms has significant clinical implications.